| Mind Over Matter, Llc | |
|
30 Crawford St Gardner MA 01440-3128 | |
| (978) 660-0996 | |
| Not Available |
| Full Name | Mind Over Matter, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 Crawford St, Gardner, Massachusetts |
| Authorized Official Name and Position | Jill Kathleen Masure (OWNER) |
| Authorized Official Contact | 9786600996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Over Matter, Llc 30 Crawford St Gardner MA 01440-3128 Ph: (978) 660-0996 | Mind Over Matter, Llc 30 Crawford St Gardner MA 01440-3128 Ph: (978) 660-0996 |
| NPI Number | 1982893392 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 10/22/2007 |
| Medicare PECOS PAC ID | 1355425125 |
|---|---|
| Medicare Enrollment ID | O20080304000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982893392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 114027 (Massachusetts) | Primary |
| Provider Name | Jill K Masure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184792335 PECOS PAC ID: 1557445327 Enrollment ID: I20080304000049 |
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